| Id Substrate, Pllc | |
|
4500 N 32nd St Ste 100a Phoenix AZ 85018-3360 | |
| (602) 200-8690 | |
| (602) 264-8107 |
| Full Name | Id Substrate, Pllc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 4500 N 32nd St Ste 100a, Phoenix, Arizona |
| Authorized Official Name and Position | Dawn M Craig (ADMINISTRATOR) |
| Authorized Official Contact | 6025617806 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Id Substrate, Pllc Po Box 10044 Phoenix AZ 85064-0044 Ph: (602) 405-4622 | Id Substrate, Pllc 4500 N 32nd St Ste 100a Phoenix AZ 85018-3360 Ph: (602) 200-8690 |
| NPI Number | 1043930662 |
|---|---|
| Provider Enumeration Date | 09/01/2022 |
| Last Update Date | 09/01/2022 |
| Certification Date | 08/29/2022 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1043930662 | NPI | - | NPPES |
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